"The most common way people give up their power is by thinking they don't have any." :: Alice Walker ::

Monday, May 08, 2006

Insider Igorance

this is a message to all healthcare staff, nurses, doctors, administrators and students.

a patient's mom fell and broke her arm about six weeks ago. after spending nearly 16 hours in the ER, she got good care, was splinted and sent home to heal. after a month, she had a follow-up appointment where it was determined that she was healing poorly, technically called a "mal-union." she was scheduled for a pre-op surgical appointment last week. her adult son accompanied her because she doesn't speak English and has trouble advocating for herself in big systems. he reports that he was told that he was not aloud to accompany her into the visit and had to wait outside. he is a humble man and accepted that at face value without challenging his right to participate. the surgery was discussed, a date was chosen, the patient was sent home and the patient didn't understand a thing.

if possible, i'd like for her to have local instead of general anesthesia to reduce surgical complications and recovery time. she has no idea what kind of anesthesia they are going to use. her son had been prepped by me to ask that question but he wasn't aloud in.

we are getting closer to the message for healthcare workers.

i called this week to try to track down the surgeon. i made it to the right clinic and spoke with a receptionist. i shared my concerns and told her about how the patient's son wasn't aloud to participate in the visit. she became defensive and then flatly denied that the patient's son wasn't aloud to participate, stating that it wasn't policy to exclude family members from visits, and finally, that it didn't really matter because they have interpretation services available so the patient should have been fine on her own.

we will never improve our systems, our quality of care, our ability to care for people who are more vulnerable, if we maintain a defensive, ignorant posture when patients and families share their stories of poor treatment or mis-treatment.

noone is perfect, systems are far from perfect. this isn't a tirade to try to make everything perfect. it's a call to those reading to please stay humble, listen and believe your patients, take what they say with a grain of salt of course, but don't discard the concerns raised because they don't fit nicely into what is supposed to be happening per stated policy.

Comments:

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what's "to the teeth"?

To the Teeth is a weblog discussing issues of health justice, medicine, race in America,
public health in its broadest sense, healthcare at a local clinic level, and honest discussions around strategies in advocacy. Ok, so it's not so focused, but it's all connected. The regulars who post to this site are:

and Andru Ziwasimon, a family medicine physician in Albuquerque, New Mexico, and a lead member of the Community Coalition for
Healthcare Access, a diverse group of providers/patients/advocates addressing access issues with the state hospital system, translation and interpretation issues, billing for under and uninsured patients, and other disparities locally.
He created and runs a sustainable and innovative clinic that serves
uninsured patients with quality care and fair prices. He also serves on the leadership of the National Physicians Alliance. (email: aziwa-at-null-dot-net)

They caught the peasant walking home from the field.
On the dark road they gagged him and cut off his nose.
This they took to the museum and stuck to the king's noseless statue.
Thus was born the history that is taught in schools.
- Amitava Kumar, "History"

Willing to Fight

From Ani Difranco's "Willing to Fight":
"'cause i know the biggest crime
is just to throw up your hands
say
this has nothing to do with me
i just want to live as comfortably as i can
you got to look outside your eyes
you got to think outside your brain
you got to walk outside you life
to where the neighborhood changes"

Excerpts of lyrics to Ani Difranco's poem "Self-evident" (hear her recite this poem on her official website:

yes,
us people are just poems
we're 90% metaphor
with a leanness of meaning
approaching hyper-distillation...
here's a toast to the folks living on the pine ridge reservation
under the stone cold gaze of mt. rushmore

here's a toast to all those nurses and doctors
who daily provide women with a choice
who stand down a threat the size of oklahoma city
just to listen to a young woman's voice

here's a toast to all the folks on death row right now
awaiting the executioner's guillotine
who are shackled there with dread and can only escape into their heads
to find peace in the form of a dream

cuz take away our playstations
and we are a third world nation
under the thumb of some blue blood royal son
who stole the oval office and that phony election
i mean
it don't take a weatherman
to look around and see the weather
jeb said he'd deliver florida, folks
and boy did he ever

and we hold these truths to be self evident:
#1 george w. bush is not president
#2 america is not a true democracy
#3 the media is not fooling me
cuz i am a poem heeding hyper-distillation
i've got no room for a lie so verbose
i'm looking out over my whole human family
and i'm raising my glass in a toast

here's to our last drink of fossil fuels
let us vow to get off of this sauce
shoo away the swarms of commuter planes
and find that train ticket we lost
cuz once upon a time the line followed the river
and peeked into all the backyards
and the laundry was waving
the graffiti was teasing us
from brick walls and bridges
we were rolling over ridges
through valleys
under stars
i dream of touring like duke ellington
in my own railroad car
i dream of waiting on the tall blonde wooden benches
in a grand station aglow with grace
and then standing out on the platform
and feeling the air on my face
give back the night its distant whistle
give the darkness back its soul
give the big oil companies the finger finally
and relearn how to rock-n-roll...

subcity

Lyrics from Tracy Chapman's "Subcity"

People say it doesn't exist
'Cause no one would like to admit
That there is a city underground
Where people live everyday
Off the waste and decay
Off the discards of their fellow man

Here in subcity life is hard
We can't receive any government relief
I'd like to please give Mr. President my honest regards
For disregarding me

They say there's too much crime in these city streets
My sentiments exactly
Government and big business hold the purse strings
When I worked I worked in the factories
I'm at the mercy of the world
I guess I'm lucky to be alive
They say we've fallen through the cracks
They say the system works
But we won't let it
Help
I guess they never stop to think
We might not just want handouts
But a way to make an honest living
Living this ain't living

the revolution will not be televised

Lyrics from Gill Scott Heron's "The Revolution Will Not Be Televised"

You will not be able to stay home, brother.
You will not be able to plug in, turn on and cop out.
You will not be able to lose yourself on skag and skip,
Skip out for beer during commercials,
Because the revolution will not be televised.

The revolution will not be televised.
The revolution will not be brought to you by Xerox
In 4 parts without commercial interruptions.
The revolution will not show you pictures of Nixon
blowing a bugle and leading a charge by John
Mitchell, General Abrams and Spiro Agnew to eat
hog maws confiscated from a Harlem sanctuary.
The revolution will not be televised.

The revolution will not be brought to you by the
Schaefer Award Theatre and will not star Natalie
Woods and Steve McQueen or Bullwinkle and Julia.
The revolution will not give your mouth sex appeal.
The revolution will not get rid of the nubs.
The revolution will not make you look five pounds
thinner, because the revolution will not be televised, Brother.

There will be no pictures of you and Willie May
pushing that shopping cart down the block on the dead run,
or trying to slide that color television into a stolen ambulance.
NBC will not be able predict the winner at 8:32
or report from 29 districts.
The revolution will not be televised.

There will be no pictures of pigs shooting down
brothers in the instant replay.
There will be no pictures of pigs shooting down
brothers in the instant replay.
There will be no pictures of Whitney Young being
run out of Harlem on a rail with a brand new process.
There will be no slow motion or still life of Roy
Wilkens strolling through Watts in a Red, Black and
Green liberation jumpsuit that he had been saving
For just the proper occasion.

Green Acres, The Beverly Hillbillies, and Hooterville
Junction will no longer be so damned relevant, and
women will not care if Dick finally gets down with
Jane on Search for Tomorrow because Black people
will be in the street looking for a brighter day.
The revolution will not be televised.

There will be no highlights on the eleven o'clock
news and no pictures of hairy armed women
liberationists and Jackie Onassis blowing her nose.
The theme song will not be written by Jim Webb,
Francis Scott Key, nor sung by Glen Campbell, Tom
Jones, Johnny Cash, Englebert Humperdink, or the Rare Earth.
The revolution will not be televised.

The revolution will not be right back after a message
bbout a white tornado, white lightning, or white people.
You will not have to worry about a dove in your
bedroom, a tiger in your tank, or the giant in your toilet bowl.
The revolution will not go better with Coke.
The revolution will not fight the germs that may cause bad breath.
The revolution will put you in the driver's seat.

The revolution will not be televised, will not be televised,
will not be televised, will not be televised.
The revolution will be no re-run brothers;
The revolution will be live.